Welcome to the 2016 Annual Survey of Entrepreneurs · 2017. 6. 21. · 1 REPORT ONLINE - DO NOT RETURN. Welcome to the 2016 Annual Survey of Entrepreneurs . DO NOT use this worksheet

1 REPORT ONLINE - DO NOT RETURN

Welcome to the 2016 Annual Survey of Entrepreneurs DO NOT use this worksheet to respond to the survey, it is intended to assist you with gathering and preparing your data prior to reporting online. Please view the online report for specific instructions.

Return to https://econhelp.census.gov/ase when you are ready to report online.

CONTACT INFORMATION Please enter the first and last name of the person who is filling out this survey. We request a telephone number so we can contact you if there is a question.

Contact Name: Phone: Ext: Email:

NUMBER OF OWNERS In 2016, how many people owned this business?

•• Do not combine two or more owners to create one owner.

Count spouses and partners as separate owners.1 person – Skip to Business - 10 % or More Ownership2 people – Skip to Business - 10 % or More Ownership3 people – Skip to Business - 10 % or More Ownership4 people – Skip to Business - 10 % or More Ownership5-10 people – Skip to Business - 10 % or More Ownership11 or more peopleBusiness is owned by a parent company, estate, trust, or other entityDon’t know

BUSINESS OWNERSHIP - GOVERNMENT OR TRIBAL ENTITY In 2016, was this business owned by a government or tribal entity?

Yes No

BUSINESS - 10% or MORE OWNERSHIP In 2016, did at least one person own 10% or more of this business? (Do not count parent companies, estates, trusts or other entities.)

Yes

No – Select “No” ONLY if no person owned 10% or more of this business.

PERCENT OWNERSHIP For the person(s) owning the largest percentage(s) in this business in 2016, please list the percentage owned by each person and his or her name.

• Do not report percentages owned by parent companies, estates, trusts, or other entities.• If more than 4 people owned this business equally, select any 4 people.• Round percentages to whole numbers. For example, report 1/3 ownership as 33%.

If there is no owner, please report 0%.

Percentage Owned (Estimates are acceptable) Name of Person Owner 1: Owner 2: Owner 3: Owner 4:

•

https://econhelp.census.gov/ase


OWNER 1 – If applicable, if not skip to page 18

INITIAL ACQUISITION How did Owner 1 initially acquire ownership of this business? Select all that apply.

Founded or started Purchased Inherited Received transfer of ownership or gift

INITIAL ACQUISITION YEAR In what year did Owner 1 initially acquire ownership of this business?

Year Don’t Know _________

JOB FUNCTION(S) In 2016, which of the following were Owner 1’s function(s) in this business? Select all that apply.

Managing day-to-day operations Providing services and/or producing goods Financial control with the authority to sign loans, leases, and contracts None of these functions

AVERAGE NUMBER OF HOURS WORKED In 2016, what was the average number of hours per week that Owner 1 spent managing or working in this business?

None 40 hours Less than 20 hours 41-59 hours 20-39 hours 60 hours or more

PRIMARY INCOME SOURCE In 2016, did this business provide Owner 1’s primary source of personal income?

Yes No

PRIOR BUSINESS OWNERSHIP Prior to establishing, purchasing, or acquiring this business, how many previous businesses has Owner 1 owned?

0 1 2 3 4 5 or more


EDUCATION PRIOR TO OWNING THE BUSINESS What was the highest degree or level of school Owner 1 completed prior to establishing, purchasing, or acquiring this business?

Less than high school graduate High school graduate - Diploma or GED Technical, trade, or vocational school Some college, but no degree Associate Degree Bachelor’s Degree Master’s, Doctorate, or Professional Degree

FIELD OF HIGHEST DEGREE PRIOR TO OWNING THE BUSINESS Prior to establishing, purchasing, or acquiring this business, what was the field of the highest degree completed for Owner 1? Select all that apply.

Agriculture, Environmental and Related Architecture and Building Business or Finance Education Engineering and Related Technologies Food or Hospitality Health, Medicine or Pharmacy Humanities or Arts Information Technology or Computer Science Law or Legal Studies Mathematics, Economics, or Statistics Natural and Physical Sciences Social Sciences Other (Specify) C

_________________________________________________________________ No Bachelor’s, Master’s, Doctorate, or Professional Degree Don’t know

SEX What is the sex of Owner 1?

Male Female

AGE What was the age of Owner 1 as of December 31, 2016?

Under 25 45-54 25-34 55-64 35-44 65 or over

U.S. CITIZENSHIP Was Owner 1 born a citizen of the United States?

Yes No


ETHNICITY Is Owner 1 of Hispanic, Latino, or Spanish origin?

No, not of Hispanic, Latino, or Spanish origin Yes, Mexican, Mexican American, Chicano Yes, Puerto Rican Yes, Cuban Yes, another Hispanic, Latino, or Spanish origin - Enter origin, for example, Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on. C

__________________________________________________________________________

RACE What is Owner 1’s race? Select all that apply. (For this survey, Hispanic origins are not races.)

White Black or African American

American Indian or Alaska Native - Enter name of enrolled or principal tribe. C

__________________________________________________________________________

Asian Indian Japanese Native Hawaiian Chinese Korean Guamanian or Chamorro Filipino Vietnamese Samoan

Other Asian - Enter race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on. C

__________________________________________________________________________

Other Pacific Islander - Enter race, for example, Fijian, Tongan, and so on. C

__________________________________________________________________________

Some other race - Enter race. C

__________________________________________________________________________


MILITARY SERVICE Has Owner 1 ever served in any branch of the U.S. Armed Forces, including the Coast Guard, the National Guard, or a Reserve component of any service branch?

Yes No – Skip to Reasons for Owning the Business

(If yes) Do any of the following characteristics describe Owner 1’s military service? Select all that apply. Served on active duty military service, not including training for the Reserves or National Guard Disabled as the result of illness or injury incurred or aggravated during military service Served on active duty military service after September 11, 2001 Served on active duty military service in 2016 Served in the National Guard or as a reservist of any branch of the U.S. Armed Forces in 2016 None of the above

REASONS FOR OWNING THE BUSINESS How important to Owner 1 are each of the following reasons for owning this business? Select one for each row.

Not Important

Somewhat Important

Very Important

Wanted to be my own boss

Flexible hours

Balance work and family

Opportunity for greater income/Wanted to build wealth

Best avenue for my ideas/goods/services

Couldn’t find a job/Unable to find employment

Working for someone else didn’t appeal to me

Always wanted to start my own business

An entrepreneurial friend or family member was a role model

Other (Specify) C


OWNER 2 - If applicable, if not skip to page 18










Yes No


0 1 2 3 4 5 or more



Less than high school graduate High school graduate- Diploma or GED Technical, trade, or vocational school Some college, but no degree Associate Degree Bachelor’s Degree Master’s, Doctorate, or Professional Degree





Male Female


Under 25 45-54 25-34 55-64 35-44 65 or over


Yes No



No, not of Hispanic, Latino, or Spanish origin Yes, Mexican, Mexican American, Chicano Yes, Puerto Rican Yes, Cuban Yes, another Hispanic, Latino, or Spanish origin- Enter origin, for example, Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on. C

___________________________________________________________________________




__________________________________________________________________________



__________________________________________________________________________


__________________________________________________________________________


____________________________________________________________________






Not Important

Somewhat Important

Very Important


Flexible hours








Other (Specify) C












Yes No


0 1 2 3 4 5 or more








Male Female


Under 25 45-54 25-34 55-64 35-44 65 or over


Yes No




___________________________________________________________________________




___________________________________________________________________________



__________________________________________________________________________


__________________________________________________________________________


__________________________________________________________________________






Not Important

Somewhat Important

Very Important


Flexible hours








Other (Specify) C






Year Don’t Know ________






Yes No


0 1 2 3 4 5 or more








Male Female


Under 25 45-54 25-34 55-64 35-44 65 or over


Yes No




___________________________________________________________________________




___________________________________________________________________________



__________________________________________________________________________


__________________________________________________________________________


__________________________________________________________________________






Not Important

Somewhat Important

Very Important


Flexible hours








Other (Specify) C


Business Specific Questions

The next questions apply to the entire business and only require one response from the respondent regardless of how many owners were entered.

ONE FAMILY MAJORITY OWNERSHIP In 2016, did two or more members of one family own the majority of this business? (Family refers to spouses/unmarried partners, parents/guardians, children, siblings, or close relatives.)

Yes No

JOINT OWNERSHIP Did spouses/unmarried partners jointly own this business?

Yes No – Skip to Business Aspirations

EQUAL OPERATION Was this business operated equally by both spouses/unmarried partners?

Yes, equally operated by spouses/unmarried partners No, primarily operated by Owner 1 No, primarily operated by Owner 2

BUSINESS ASPIRATIONS Where would the owner(s) like this business to be in five years? Select one.

Larger in terms of sales or profits About the same amount of sales or profits Smaller in terms of sales or profits Other (Specify) C

_______________________________________________________________________________

FUNDING FROM OWNER(S) For 2016, what was the total amount of money that the owner(s) personally put into the business? Your best estimate is fine. Please report in thousands. Include:

• Investments from personal savings• Personal retirement accounts• Home equity loans• Personally borrowed funds

$____________ ,000

YEAR OF BUSINESS ESTABLISHMENT In what year was this business originally established?

Year Don’t know __________

FRANCHISE OPERATION In 2016, did all or part of this business operate as a franchise?

Yes No


CAPITAL FUNDING For the owner(s) you reported, what was the source(s) of capital used to start or initially acquire this business? If you did not report any owners, skip to Amount of Capital Needed to Start or Initially Acquire Business. Select all that apply.

Personal/family savings of owner(s) Personal/family assets other than savings of owner(s) Personal/family home equity loan Personal credit card(s) carrying balances Business credit card(s) carrying balances Government-guaranteed business loan from a bank or financial institution, including SBA-guaranteed loans Business loan from a bank or financial institution Business loan from federal, state, or local government Business loan/investment from family/friend(s) Investment by venture capitalist(s) Grants Other source(s) of capital Don’t know None needed – Skip to Funding from Family, Friends, and Employees

AMOUNT OF CAPITAL NEEDED TO START OR INITIALLY ACQUIRE THE BUSINESS For the owner(s) you reported, what was the total amount of capital used to start or initially acquire this business? (Capital includes savings, other assets, and borrowed funds of owner(s).)

Less than $5,000 $100,000 - $249,999 $5,000 - $9,999 $250,000 - $999,999 $10,000 - $24,999 $1,000,000 - $2,999,999 $25,000 - $49,999 $3,000,000 or more $50,000 - $99,999 Don’t know

FUNDING FROM FAMILY, FRIENDS, AND EMPLOYEES For 2016, what was the total amount of money this business received from family, friends, and employees? Your best estimate is fine. Please report in thousands.

$____________ ,000

FUNDING FROM BANKS OR OTHER FINANCIAL INSTITUTIONS For 2016, what was the total amount of money this business borrowed from a bank or other financial institution, including business loans, a business credit card carrying a balance, or a business line of credit? Include all draws on a business line of credit, even if paid off during the year. Your best estimate is fine. Please report in thousands.

$____________ ,000

FUNDING FROM OUTSIDE INVESTORS For 2016, what was the total amount of money this business received from angel investors, venture capitalists, or other businesses in return for a share of ownership in this business? Your best estimate is fine. Please report in thousands. (An “angel investor” is an affluent individual who provides capital for a business start-up, usually in exchange for convertible debt or ownership equity.)

$____________ ,000


FUNDING FROM GOVERNMENT GRANTS For 2016, what was the total amount of money this business received from government grants (such as the Small Business Innovation Research (SBIR) and/or Small Business Technology Transfer (STTR) programs)? Your best estimate is fine. Please report in thousands.

$____________ ,000

NEW FUNDING RELATIONSHIPS In 2016, did this business attempt to establish any new funding relationship (for example, loans, investments, or gifts) with any of the following sources? (Select one for each row.)

No Yes, received total

amount of the funding requested

Yes, but did notreceive the total

amount requested

Other owner(s) (if applicable)

Family, friends, or employees

Banks, credit unions, or other financial institutions

Home equity loans in name of business owners

Credit cards

Trade credit (for example, buy now, pay later)

Angel investors

Venture capitalists

Other investor businesses

Crowdfunding platform (for example, Prosper, Kickstarter, etc.)

Grants (for example, federal government’s Small Business Technology Transfer Program (STTR) or Small Business Innovation Research Program (SBIR))

Other (Specify) C

________________________________________________________________________________


BUSINESS BANKING RELATIONSHIPS In 2016, were this business’s banking relationships with the same financial institutions as any of the owner’s personal banking relationships? Banking relationships include business checking or savings accounts, credit cards, loans, etc. Select one.

Yes No – Skip to Outstanding Loans The owner(s) had no business banking relationships – Skip to Outstanding Loans Don’t know – Skip to Outstanding Loans

BANKING RELATIONSHIP DURATION How long were the owner's personal banking relationships in place before financial transactions were first conducted by this business? Select one.

0 - 1 month 2 - 5 months 6 - 12 months More than 12 months Don’t know

OUTSTANDING LOANS In 2016, was this business required to provide collateral or loan guarantee for any outstanding loan? Select one.

Business did not have an outstanding loan Yes No Don’t Know

PURCHASES ON ACCOUNT In 2016, did this business make any purchases on account or using trade credits? Trade credits are invoice payment terms a business establishes with their suppliers allowing them to purchase goods or services now and pay at a later date.

Yes No

AVOIDANCE OF ADDITIONAL FINANCING At any time during 2016, did this business need additional financing?

Yes, business needed additional financing and the owner(s) chose not to apply Yes, business needed additional financing and the owner(s) did apply – Skip to Profitability No, business did not need additional financing – Skip to Profitability

AVOIDANCE OF ADDITIONAL FINANCING - CONTINUED Why did this business choose not to apply for additional financing? Select all that apply.

Did not think business would be approved by lender Did not want to accrue debt Decided the financing costs would be too high Preferred to reinvest the business profits instead Felt the loan search/application process would be too time consuming Decided the additional financing was no longer needed Decided to wait until funding conditions improved Decided to wait until company hit milestones to be in stronger position to raise funds Other (Specify) C

________________________________________________________________________________


PROFITABILITY For 2016, did this business have profits, losses, or break even? Select one.

Profits Losses Break even

NEGATIVE IMPACT ON PROFITABILITY For 2016, did each of the following negatively impact the profitability of this business? Select one in each row.

Yes No

Access to financial capital

Cost of financial capital

Finding qualified labor

Taxes

Government regulations (federal, state, and/or local)

Slow business or lost sales

Customers or clients not making payments or paying late

The unpredictability of business conditions

Changes or updates in technology

Other (Specify) C

________________________________________________________________________________


TYPES OF REGULATIONSFor 2016, what impact did each of the following types of government regulations have on this business’s profitability? (Select one in each row.)

Very Somewhat No Somewhat Very Not Negative Negative Impact Positive Positive Applicable

Employee hiring

Workers’ compensation

Occupational health and safety

Health insurance

Employment records

Business and professional licensing

Building and renovation permits

Business registration

Health permits and inspections

Environmental

Trade

Financial

Other (Specify) C

_____________________________________________________________________________________

REGULATIONS AND STARTING OR ACQUIRING THE BUSINESS What impact did regulations have on the ability to initially start or acquire this business?

Positive impact Negative impact No impact Don’t know

REGULATIONS AND GROWTH OF THE BUSINESS During 2016, what impact did regulations have on expanding this business’s operations, such as by increasing production, adding locations, or attaining new customers?

Positive impact Negative impact No impact Business did not plan to expand operations Don’t know


REASONS FOR SEEKING BUSINESS ADVICE During 2016, what was this business’s primary reason(s) for seeking paid or unpaid business advice or mentoring from others? Select all that apply.

Employee relations (for example, hiring, workforce retention, employee performance/growth, employee separation) Management and day-to-day operations Product development and innovation Investment and access to capital Succession planning and exit strategy Increasing sales Reducing costs Taxes and accounting Business finances Regulatory compliance Technology/Information Technology Key performance indicators and business targets Copyrights, trademarks, and patents Legal Did not seek advice/mentoring – Skip to Exit Strategy Other (Specify) C

________________________________________________________________________________

PROVIDERS OF BUSINESS ADVICE During 2016, from whom did this business seek the advice or mentoring selected in the ‘Reasons for Seeking Business Advice’ question? Select all that apply.

Family (Family refers to spouses/unmarried partners, parents/guardians, children, siblings, or close relatives.) Friends Professional colleagues Employees Legal and professional advisors Customers Suppliers Government-supported technical assistance program (for example, Small Business Administration (SBA) Small Business Development Center, Women's Business Center, or Minority Business Development Agency (MBDA) Business Center) Other (Specify) C

________________________________________________________________________________

OUTCOME OF ADVICE OR MENTORING During 2016, did the advice or mentoring selected in the ‘Reasons for Seeking Business Advice’ question lead to positive business outcomes or changes in business operations that are anticipated to be positive?

Yes No


EXIT STRATEGY Which of the following best describes this business’s current exit strategy for any of the owners? An exit strategy is a plan the business owners create to describe how they intend to exit the business and capture their investment. Select all that apply.

Walk away from the business Liquidate or sell off assets and repay the business’s liabilities Sell the business to employees or managers (for example, offer an Employee Stock Ownership Plan (ESOP), management buyout, or employee buyout) Sell or merge the business with another firm Sell the business to another individual that is not an owner of the same business Sell or transfer ownership to another owner of the same business Sell or transfer ownership of the business to a family member(s) that is not an owner of the same business Prepare an Initial Public Offering (IPO) Other (Specify) C

________________________________________________________________________________ Business does not currently have an exit strategy for any owner

TYPES OF CUSTOMERS In 2016, which of the following types of customers accounted for 10% or more of this business’s total sales of goods and/or services? Select all that apply.

Federal government State and local government, including school districts, transportation authorities, etc. Other businesses, including distributors of your productsOther organizations (foreign governments, nonprofits, etc.)Individuals

CUSTOMER LOCATIONS During 2016, where were this business’s customers or clients located? Round to the nearest whole percent. Your best estimate is fine. If none, report “0.”

Same region as the business ____%

Outside of the region but within the U.S. (Domestic) ____%

Outside the United States (International) ____%

TOTAL 100%

SALES OF EXPORTS OUTSIDE THE UNITED STATES In 2016, what percent of this business’s total sales of goods and/or services consisted of exports outside the United States?

______% None Don’t know

OPERATIONS OUTSIDE THE UNITED STATES In 2016, did this business have operations outside the United States?

Yes No

OUTSOURCING OR TRANSFERS OUTSIDE THE UNITED STATES In 2016, did this business outsource or transfer any business function and/or service to another company outside the United States?

Yes No


LANGUAGE(S) In 2016, which language(s) did this business conduct transactions with its customers? Select all that apply.

English German Portuguese African language(s) Hindi/Urdu Russian Arabic Italian Spanish Chinese Japanese Tagalog French Korean Vietnamese French Creole Polish Other

TYPES OF WORKERS In 2016, which of the following types of workers were used by this business? Select all that apply.

Full-time paid employees (workers who received a W-2) Part-time paid employees (workers who received a W-2) Paid day laborers Temporary staffing obtained from a temporary help service Leased employees from a leasing service or a professional employer organization Contractors, subcontractors, independent contractors, or outside consultants (workers who received a 1099 or payment from another company) None of the above

EMPLOYEE BENEFITS In 2016, which of the following employee benefits were paid totally or partly by this business? Select all that apply.

Health insurance Contributions to retirement plans, including 401(k), Keogh, etc. Profit sharing and/or stock options Paid holidays, vacation, and/or sick leave Tuition assistance and/or reimbursement None of the above

WEBSITE In 2016, did this business have a website?

Yes No

E-COMMERCE In 2016, did this business have any e-commerce sales? (E-commerce sales are sales of goods and/or services where an order is placed by the buyer or price and terms of the sale are negotiated over the Internet, extranet, EDI network, electronic mail, or other online system. Payment may or may not be made online.)

Yes No – Skip to Home Operation

PERCENTAGE OF E-COMMERCE In 2016, what percent of this business’s total sales of goods and/or services were e-commerce sales?

Less than 1% 20% - 49% 1% - 4% 50% - 99% 5% - 9% 100% 10% - 19% Don’t know


HOME OPERATION In 2016, did this business operate primarily from somebody’s home?

Yes No

COPYRIGHTS, TRADEMARKS, AND PATENTS In 2016, did this business own one or more of the following? Select all that apply.

Copyright Patent (granted) None Trademark Patent (pending)

BUSINESS ACTIVITY CHARACTERISTICS In 2016, did any of the following characteristics describe the activity of this business? Select all that apply.

Operated less than 40 hours per week on average Operated less than 12 months Seasonal business (for example, fireworks sales or tax preparer) Operated occasionally (for example, event organizer or guest speaker) None of the above

CURRENTLY OPERATING Is this business currently operating?

Yes – Skip to Remarks No

CEASE OPERATION Did the operations cease for any of the following reasons? Select all that apply.

Owner’s military deployment Lack of business loans/credit Owner’s illness or injury Lack of personal loans/credit Owner(s) retired Started another business Owner(s) deceased Sold this business Operated for a specific or one-time event Other Inadequate cash flow or low sales

REMARKS Please use this space for any explanations that may be essential in understanding your reported data.

THANK YOU

Documents

Welcome to the 2016 Annual Survey of Entrepreneurs · 2017. 6. 21. · 1 REPORT ONLINE - DO NOT RETURN. Welcome to the 2016 Annual Survey of Entrepreneurs . DO NOT use this worksheet